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General NPI Number Information
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NPI Number | 1649320524
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Entity Type | Organization
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Legal Business Name | ASPIRUS KEWEENAW
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 110 CALUMET STREET
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City | LAKE LINDEN
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State | MI
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Zip | 49945-1308
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Country | US
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Telephone | 906-296-5040
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Fax | 906-296-1006
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Provider Business Mailing Address
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Address Line | 205 OSCEOLA STREET
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City | LAURIUM
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State | MI
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Zip | 49913-2134
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Country | US
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Telephone | 906-337-6560
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Fax | 906-337-6562
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Authorized Official
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Title or Position | SVP & CHIEF FINANCIAL OFFICER
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Name | JERRY M YANG
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Credential |
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Telephone | 715-847-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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